VIEWS: 53 PAGES: 3 CATEGORY: Family and Estate Planning POSTED ON: 3/9/2010
Durable Power of Attorney, limited to provisions for health care and extraordinary care.
DURABLE POWER OF ATTORNEY – MEDICAL CARE (Declaration of Intent Regarding Medical Care and Treatment) KNOW ALL MEN BY THESE PRESENTS: That I, ______________, birth date __________, Social Security Number __________, domiciled in _______ County, _______, mailing address _______________________, do make, constitute and appoint ________________, (Address and Phone Number), as my true and lawful attorney-in-fact, for me and in my name, place and stead, to do and to perform any and all of the actions which follow. MEDICAL CARE To make or modify any and all arrangements deemed appropriate and in my best interest for my medical and health care; to authorize, consent or request for me and in my name, or withhold my consent, that I be admitted as a patient in any care facility, nursing care facility, hospital, clinic, or other medical facility as selected by my attorney-in-fact; and to give consent for me and in my place and stead to and for any type of surgical or medical treatment or procedures, to conse
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